The opinion
NOT FOR PUBLICATION WITHOUT THE
APPROVAL OF THE APPELLATE DIVISION
This opinion shall not "constitute precedent or be binding upon any court ." Although it is posted on the
internet, this opinion is binding only on the parties in the case and its use in other cases is limited. R. 1:36-3.
SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
DOCKET NO. A-3128-23
JACK LAURIE,
Petitioner-Appellant,
v.
BOARD OF TRUSTEES,
PUBLIC EMPLOYEES'
RETIREMENT SYSTEM,
Respondent-Respondent.
Argued September 8, 2025 – Decided September 18, 2025
Before Judges Sabatino and Walcott-Henderson.
On appeal from the Board of Trustees of the Public
Employees' Retirement System, Department of the
Treasury, PERS No. xx6159.
Samuel M. Gaylord argued the cause for appellant
(Szaferman Lakind Blumstein & Blader, PC, attorneys;
Samuel M. Gaylord, on the brief).
Brian D. Ragunan, Deputy Attorney General, argued
the cause for respondent (Matthew J. Platkin, Attorney
General, attorney; Donna Arons, Assistant Attorney
General, of counsel; Brian D. Ragunan, on the brief).
PER CURIAM
The sole issue in this appeal is whether the Board of the Public Employees
Retirement System ("PERS") erred in concluding appellant failed to prove that
injuries he sustained in two separate work-related incidents in 2014 and 2017
were sufficient factors in causing his undisputed permanent disability, making
him ineligible for accidental disability retirement benefits under N.J.S.A.
43:15A-43.
As we will discuss, the Board's medical expert who testified at the hearing,
as well as the administrative law judge who relied on that expert in
recommending the denial of appellant's claim, did not explicitly apply the
causation standard prescribed by case law. Consequently, we are constrained to
vacate the Board's final agency decision, and remand for reconsideration and
rehearing using the proper causation test.
I.
Given that we are vacating the Board's decision and remanding for further
proceedings, we need not detail the facts comprehensively. The following
summary will suffice for our purposes.
At the relevant times, appellant Jack Laurie was a State employee, first
with the Department of Community Affairs ("DCA") at the time of his 2014
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accident and then with the Department of Military and Veterans Affairs
("DMAVA") at the time of his 2017 accident. His job with DMAVA involved
traveling to various work sites. In both jobs, appellant was a member of the
PERS pension system.
Appellant previously suffered a work-related injury in 2006 before he
became a State employee. Although the details of that accident are not
elaborated in our record, that accident caused him vertebral sprains and strains
as well as bulging discs. Coincidentally, appellant was examined at that time
by the same orthopedic physician he later retained in this case or a colleague in
that doctor's office. Appellant collected workers compensation benefits from
the 2006 accident and thereafter returned to work.
The first of the two State employment accidents at issue here occurred on
September 11, 2014, when appellant was injured in a motor vehicle collision at
work. He was examined by his medical expert and diagnosed with neck and low
back injuries. As a result of that 2014 accident, appellant was limited to lifting
twenty pounds. He returned to work with accommodations and transferred from
the DCA job to the DMAVA position.
The second accident occurred on August 3, 2017, when appellant heard
banging noises from the nearby handicapped bathroom and went to investigate.
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Appellant discovered one of his co-workers thrashing in his wheelchair and
rushed to assist him. Appellant managed to prevent the co-worker from falling
out of the wheelchair but, in the process, he re-injured his neck and back. His
MRIs from 2014, 2017 and 2019 revealed various disc herniations.
The parties stipulate that appellant has become permanently disabled
following the 2017 accident. Appellant applied to the PERS for disability
retirement benefits. The PERS granted him ordinary disability benefits under
N.J.S.A. 43:15A-42 but denied his claim for the more enhanced "accidental"
disability benefits under N.J.S.A. 43:15A-43. Appellant is now in his early
seventies and has moved to Florida. He no longer works.
A two day Zoom hearing of the contested case was held in the Office of
Administrative Law before an administrative law judge ("the first ALJ").
Appellant and his medical expert testified in his case. The Board presented
competing expert medical testimony from an orthopedist, as well as testimony
from a State investigator.
Before the first ALJ ruled on the merits of the case, she was appointed as
a Superior Court judge. A successor jurist ("the second ALJ") was reassigned
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the matter, pursuant to N.J.A.C. 1:1-14.13. The second ALJ reviewed the two
days of hearing transcripts, as well as written summations from counsel. 1
On March 25, 2024, the second ALJ issued a recommended decision,
concluding that: (1) appellant's 2017 workplace accident was not "undesigned
and unexpected" under the criteria of Richardson v. Bd. of Trs., Police &
Firemen's Ret. Sys., 192 N.J. 189 (2007); and (2) the 2014 and 2017 accidents
did not "directly cause" appellant's present disability. The ALJ found the
Board's medical expert's opinion that those accidents merely aggravated
appellant's pre-existing neck and back conditions more credible than that of
appellant's expert.
On review, the PERS Board issued a final agency decision on May 16,
2024, denying appellant's claim. The Board did, however, overturn the ALJ's
application of the Richardson test, concluding the 2017 bathroom accident was
"undesigned and unexpected." Even so, the Board adopted the ALJ's finding of
unproven causation.
Appellant contends the Board and the second ALJ applied incorrect and
overly stringent causation principles. He argues that an aggravation of injury
1
Neither party disputes the propriety of the second ALJ handling the case in
this manner.
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5
can be and has been qualified to establish causation in several accidental
disability cases. The Board counters that the administrative decision is
supported by substantial credible evidence in the record and is neither arbitrary
nor capricious.
With respect to the key disputed issue of causation, the applicable PERS
statute, N.J.S.A. 43:15A-43 requires an employee seeking accidental disability
benefits to establish that the employee "is permanently and totally disabled as a
direct result of a traumatic event occurring during and as a result of the
performance of his regular or assigned duties." Id. (emphases added). The
element of a qualifying traumatic event under the criteria of Richardson was
adjudicated in appellant's favor by the Board. Hence, the only remaining issue
is whether sufficient evidence of causation was established at the hearing.
As both counsel acknowledged at oral argument before us, the controlling
precedent on the causation element is Gerba v. Bd. of Trs. of Pub. Emp. Ret.
Sys., 83 N.J. 174 (1980). Gerba construed the "direct result" language of the
statute to require the employee to show the work-related injury was an "essential
significant or the substantial contributing cause of the resultant disability." Id.
at 186 (emphasis added). Although Gerba was repudiated by the Supreme Court
in Richardson on other grounds inapplicable here, Richardson, 192 N.J. at 211-
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213 (addressing Gerba's interpretation of "traumatic event"), the "essential
significant or the substantial contributing cause" element has remained unaltered
in our case law.
Neither Gerba nor the PERS statute define the terms "essential,"
"significant," or "substantial." Even so, common usage reflected in dictionary
definitions shed light on those terms. "Significant" has been defined to mean,
among other things, "of special importance; momentous as distinguished from
insignificant." Black's Law Dictionary 1666 (12th ed. 2024).
In that same vein, "substantial" has been defined as "involving substance;
material; real and not imaginary; important, essential and of real worth and
importance." Black's Law Dictionary 1734 (12th ed. 2024). "Essential"
connotes: "of, relating to, or involving the essence or intrinsic nature of
something; of the utmost importance; basic and necessary." Black's Law
Dictionary 686 (12th ed. 2024).
These concepts of significant, substantial, and essential delineated in
Gerba do not require claimants to prove that the work-related accidents at issue
were the sole causes of their disabilities. They can be a "contributing cause"
and qualify based on the extent of their impact on the claimant's condition. 83
N.J. at 187. It is logical and conceivable that a pre-existing condition could have
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been “significant” or “substantial,” and that a work-related injury could also
have been “significant” or “substantial.” One does not necessarily rule out the
other from playing a role in the chain of causation. Both the pre-existing
condition and the accident, while each being significant or substantial,
sometimes can act together to be disabling, as recognized in Gerba, and enable
the employee to recover accidental disability benefits. Id. at 184. The law does
not bar every worker who has a substantial or significant pre-existing medical
condition, who then is severely injured at work from qualifying for accidental
disability benefits. Although the work-related accident, must play an "essential"
causal role in worsening a pre-existing condition, Gerba does not state it must
be the "primary" cause.
Here, the Board's expert concluded that appellant's neck and back injuries
were not, as he phrased it in his testimony, the "primary cause" of his present
disability. Additionally, in his written report, admitted into evidence at the
hearing, the Board's expert opined that "the accidents in question exacerbated
pre-existing conditions and are not the primary cause of [appellant's] disability."
But, as expressed, that is not precisely the Gerba test. Appellant is not obligated
to prove his disabled condition was "primarily", "mainly", or "predominantly"
caused by the 2014 and 2017 accidents. Instead, he needed to prove that the
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accidents were (1) a "significant" or "substantial" contributing cause of his
present condition, and (2) were "essential" factors in producing the condition.
A pre-existing medical condition, as exists here, does not render a
claimant per se ineligible for accidental disability benefits. If the workplace
accident worsened the condition in a "significant" or "substantial" contributing
manner and was "essential" in worsening the claimant's condition to such a
degree that the claimant can no longer perform job functions, then the claimant
can still be eligible.
The Board stresses that appellant was taking pain medications prescribed
by his family practitioner before the 2014 accident. That certainly is a relevant
consideration, but the record is silent regarding the dosage or frequency of the
medication, or the severity of appellant's pain level. The pain was apparently
not so severe as to prevent appellant from continuing to work. Hence, there is
some basis to infer that the 2014 and 2017 accidents could have been "essential"
in tipping the balance.
The ALJ's decision did not cite to Gerba and did not explicitly apply its
causation standard. The decision adopted the opinions of the Board's expert and
concluded that appellant's back injuries were not the "direct and proximate
result" of the 2014 and 2017 work-related injuries. Although that conclusory
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terminology, except for the word proximate, tracks the wording of the statute,
the decision did not analyze whether the accidents were a significant or
substantial contributing cause of appellant's condition. Nor did the decision
address whether the accidents were essential in worsening appellant's condition
to such a degree that he could no longer perform his job duties.
The decision noted that appellant's medical expert "testified that it was
possible that the prior injuries, including the 2006 incident, could have
progressed." But that acknowledgment of a possible progression does not
logically foreclose that the 2014 and 2017 accidents could have played a
substantial or significant contributing role in accelerating or worsening that
progression.
The ALJ's decision notably stated that "[a]dditionally, the petitioner's
medical history was not free of issues concerning his back." The Gerba
causation standard, however, does not require claimants to prove they were
completely healthy persons who were "free of issues" before the work-related
injury. That mode of analysis imposes an overly stringent burden on claimants,
overlooking the possibility that pre-existing conditions and a new accident can
act in combination to produce a permanent disability. To be sure, Gerba
instructs that the claim should be denied if there is an underlying condition
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"which itself has not been directly caused, but is only aggravated or ignited, by
the trauma." 83 N.J. at 186. The word "only" within that observation separates
insignificant and insubstantial contributing causes from more impactful ones.
The ALJ's focus on whether appellant was "free of issues" before the two
accidents overlooks that nuance.
Ordinarily we afford substantial deference to the findings of an
administrative agency, and the credibility findings of an ALJ. See, e.g., Russo
v. Bd. of Trs., Police & Firemen's Ret. Sys, 206 N.J. 14, 27 (2011). But here,
because of the first ALJ's departure from the OAL, we have a distinctive context
in which the second ALJ was in no better position to evaluate the competing
medical experts' credibility from a cold record than we are. Moreover, the claim
of error qualifies as an error of law that we can overturn de novo because the
correct legal standard under Gerba was not used. Bowser v. Bd. of Trs. Police
& Firemen's Ret. Sys., 445 N.J. Super. 165, 170-71 (App. Div. 2018).
For these reasons, we are constrained to vacate the Board's final agency
decision and remand for rehearing and reconsideration of the case, this time
explicitly utilizing the Gerba causation standard. In an abundance of caution
and with no disrespect intended, we direct the matter to be heard anew by a
different ALJ who has not already committed to previous factual findings. In re
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Wolf, 231 N.J. Super. 365, 378 (App. Div. 1989). We leave it to the discretion
of the parties and the agency as to whether updated or additional medical
examinations are warranted. We intimate no views on the ultimate outcome.
Vacated and remanded. We do not retain jurisdiction.
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